Nat Med

BP reduction lowers dementia risk in large trial

April 24, 2025

Intensive BP reduction can effectively lower the risk of all-cause dementia in patients with uncontrolled hypertension. These findings support the implementation of community-based BP management programs to mitigate dementia risk, particularly in resource-limited settings.

Study details: The China Rural Hypertension Control Project (CRHC) (NCT03527719) open-label phase 3 trial evaluated the impact of BP reduction on all-cause dementia among 33,995 individuals aged ≥40 years with uncontrolled hypertension in rural China. Villages were randomized to either a non-physician community healthcare provider-led intervention or usual care. The intervention aimed for a systolic BP goal of <130 mm Hg and a diastolic BP goal of <80 mm Hg, using a stepped-care protocol supervised by primary care physicians.

Results: During the four-year study period, BP was reduced by 22.0/9.3 mm Hg in the intervention group compared with usual care. The intervention group had a significantly lower incidence of all-cause dementia (risk ratio [RR] 0.85; 95% confidence interval [CI] 0.76 - 0.95; P = 0.0035). Additionally, cognitive impairment without dementia was lower in the intervention group (RR 0.84; 95% CI 0.80 - 0.87; P < 0.0001). Serious adverse events were less frequent in the intervention group (RR 0.94; 95% CI 0.91 - 0.98; P = 0.0006).

Source:

He J, et al. (2025, April 21). Nat Med. Blood pressure reduction and all-cause dementia in people with uncontrolled hypertension: an open-label, blinded-endpoint, cluster-randomized trial. https://pubmed.ncbi.nlm.nih.gov/40258956/